摘要
目的 探讨经腹膜后间隙腹腔镜肾上腺肿瘤切除术及肾脏手术的应用解剖及临床价值。方法 对2002年3月至今开展的共58例腹腔镜泌尿系手术进行分析,其中肾囊肿去顶减压术41例、肾上腺肿瘤切除术16例、肾切除术1例。结果除1例肾囊肿去顶减压术因后腹膜腔制备失败改行开放手术外,其余57例手术均获成功,手术时间肾囊肿30-120.min,肾上腺70-140min,1例肾切除210 min;失血量20～100 ml,平均50 ml,术中及术后均未输血,全部患者均无并发症。结论经腹膜后间隙腹腔镜肾脏及肾上腺手术具有进路直接、解剖简单、易于掌握,对组织损伤小、出血少、对腹腔干扰小、术后恢复快、并发症少等优点,可作为肾上腺良性疾病及部分肾脏疾病手术治疗的首选方法。
Objective To explore the retroperitoneal anatomy of renal and adrenal diseases for laparoscopic operation. Methods A total of 58 cases of urologic disease were treated by retroperitoneal laparoscopy. Results The procedure was successful in the 57/58 cases, the operation time was 30 - 120 minutes for renal cystic diseases, 70 - 140 minutes for adrenal tumors and 210 minutes for one renalectomy; there was no need for blood transfusion with the blood loss range from 20 to 100 ml, Complications was not occurred during or postoperatively. Conclusion Retroperitoneal laparoscopic is a microinvasive procedure; there are safety, less bleeding,rapid postoperative recovery and less complications. It should be the first choice for most adrenal adenoma and part of the renal diseases.
